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Encyclopedia > Septic arthritis
Septic arthritis
Classification and external resources
ICD-10 M00.-M03.
ICD-9 711.0
DiseasesDB 29523
eMedicine med/3394 
MeSH D001170

Septic arthritis is the invasion of a joint by an infectious agent which produces arthritis. The usual etiology is bacterial, but viral, mycobacterial, and fungal arthritis occur occasionally. Bacteria are carried by the bloodstream from an infectious focus elsewhere, introduced by a skin lesion that penetrates the joint, or by extension from adjacent tissue (e.g. bone or bursae). The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... For other uses, see Joint (disambiguation). ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... This article is about the medical term. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... This article is about biological infectious particles. ... Species see text Mycobacterium is the a genus of actinobacteria, given its own family, the Mycobacteriaceae. ... For the fictional character, see Fungus the Bogeyman. ... For other uses, see Skin (disambiguation). ... Skin lesions caused by Chickenpox A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. ...

Contents

Etiology

Micro-organisms must reach the synovial membrane of a joint. This can happen in any of the following ways: The synovium or synovial membrane is a thin, weak layer of tissue which lines the non-cartilaginous surfaces within the joint space, sealing it from the surrounding tissue. ...

  • dissemination of pathogens via the blood, from abscesses or wound infections,
  • dissemination from an acute osteomyelitic focus,
  • dissemination from adjacent soft tissue infection,
  • entry via penetrating trauma
  • entry via iatrogenic means.[1]

Bacteria that are commonly found to cause septic arthritis are: A pathogen (from Greek pathos, suffering/emotion, and gene, to give birth to), infectious agent, or more commonly germ, is a biological agent that causes disease or illness to its host. ... For the death metal band, see Abscess (band). ... In medicine, the term soft tissue refers to tissues that connect, support, or surround other structures and organs of the body. ... Penetrating trauma is an injury that occurs primarily by an object piercing the skin or entering a tissue of the body. ... An iatrogenic (pronounced , IPA) condition is a state of ill health or adverse effect caused by medical treatment, usually due to mistakes made in treatment. ...

  • Staphylococcus Aureus - the most common cause in adults
  • Haemophilus Influenzae - the most common cause in children
  • Neisseria Gonorrhoea - in young adults
  • Escherichia Coli - in the elderly, IV drug users and the seriously ill
  • M. Tuberculosis, Salmonella spp. and Brucella spp. - cause septic spinal arthritis [2]

In bacterial infection, Pseudomonas aeruginosa has been found to infect joints, especially in children who have sustained a puncture wound. This bacteria also causes endocarditis.[3] E. coli redirects here. ... Species S. enterica This article is about the bacteria. ... Species B. abortus B. melitensis Brucella is a genus of Gram-negative bacteria. ... Binomial name Pseudomonas aeruginosa (Schroeter 1872) Migula 1900 Synonyms Bacterium aeruginosum Schroeter 1872 Bacterium aeruginosum Cohn 1872 Micrococcus pyocyaneus Zopf 1884 Bacillus aeruginosus (Schroeter 1872) Trevisan 1885 Bacillus pyocyaneus (Zopf 1884) Flügge 1886 Pseudomonas pyocyanea (Zopf 1884) Migula 1895 Bacterium pyocyaneum (Zopf 1884) Lehmann and Neumann 1896 Pseudomonas polycolor... Endocarditis is an inflammation of the inner layer of the heart, the endocardium. ...


Indications

Septic arthritis should be suspected when one joint (monoarthritis) is affected and the patient is febrile. In seeding arthritis, several joints can be affected simultaneously; this is especially the case when the infection is caused by staphylococcus or gonococcus bacteria. Monoarthritis is inflammation (arthritis) of one joint at a time. ... An analogue medical thermometer showing the temperature of 38. ... Species S. aureus S. caprae S. epidermidis S. haemolyticus S. hominis S. lugdunensis S. pettenkoferi S. saprophyticus S. warneri S. xylosus Staphylococcus (in Greek staphyle means bunch of grapes and coccos means granule) is a genus of Gram-positive bacteria. ... Neisseria gonorrhoeae is a species of Gram-negative (see also Gram Stain) bacteria responsible for the disease gonorrhoea. ...


Diagnosis is by aspiration (giving a turbid, non-viscous fluid), Gram stain and culture of fluid from the joint, as well as tell-tale signs in laboratory testing (such as a highly elevated neutrophils (approx. 90%), ESR or CRP). Gram staining is a method for staining samples of bacteria that differentiates between the two main types of bacterial cell wall. ... A microbiological culture is a way to determine the cause of infectious disease by letting the agent multiply (reproduce) in predetermined media. ... Neutrophil granulocytes (commonly referred to as neutrophils) are a class of white blood cells and are part of the immune system. ... The erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ... CRP may mean: Calgary Regional Partnership, a cooperative of economically associated municipalities in Calgary, Alberta, Canada Carbon fiber reinforced plastic (CFRP or CRP), a strong, light and expensive material Committee to Re-elect the President (CRP or CREEP), a Nixon White House fund-raising organization Conservation Reserve Program, a voluntary...


Treatment

Therapy is usually with intravenous antibiotics, analgesia and washout/aspiration of the joint to dryness. An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Staphylococcus aureus - Antibiotics test plate. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ...


Radiologic Findings

Traditionally, the diagnosis of septic arthritis was based on clinical assessment and prompt arthrocentesis. However, the clinical picture may be obscured by multiple confounding factors and a paucity of specific findings especially for the deep joints, ie. the hip or shoulder. Imaging can be used to confirm the diagnosis of septic arthritis and more importantly, imaging findings suggestive of septic arthritis can direct the clinician to a diagnosis that may not have been considered. Arthrocentesis is the clinical procedure of using a syringe to collect synovial fluid from a joint capsule. ...


Plain film findings of septic arthritis include: joint effusion, soft tissue swelling, periarticular osteoporosis, loss of joint space, marginal and central erosions and bone ankylosis. CT is more sensitive than plain films for the detection of early bone destruction and effusion. Ankylosis, or Anchylosis is a stiffness of a joint, the result of injury or disease. ...


The role of MRI in the diagnosis of septic arthritis has been increasing in recent years in an effort to detect this entity earlier. Findings are usually evident within 24 hours following the onset of infection and include: synovial enhancement, perisynovial edema and joint effusion. Signal abnormalities in the bone marrow can indicate a concomitant osteomyelitis. The sensitivity and specificity of MRI for the detection of septic arthritis has been reported to be 100% and 77% respectively. The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...


See also

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Injuries from human bites present a particular risk to other humans, with a major risk of sepsis from infection by human oral bacteria and the possibility of transmission of blood-borne diseases including HIV/AIDS, syphilis and hepatitis. ...

References

  1. ^ Axford J, O'Callaghan C, (eds). 2004. Medicine. Oxford. Blackwell Publishing.
  2. ^ Axford J, O'Callaghan C, (eds). 2004. Medicine. Oxford. Blackwell Publishing.
  3. ^ Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.
  • Septic arthritis by William Brinkman, M.D., University of Washington Department of Radiology
  • Karchevsky M, Schweitzer ME, Morrison WB, Parellada JA (2004). "MRI findings of septic arthritis and associated osteomyelitis in adults". AJR Am J Roentgenol 182 (1): 119–22. PMID 14684523. 
  • Resnick, Donald (1989). Bone and joint imaging. Philadelphia: Saunders, 744-749. ISBN 0721622151. 
  • Bredella, Miriam A.; Stoller, David W.; Tirman, Phillip F. J. (2004). Diagnostic imaging. Salt Lake City, Utah: Amirsys, 4-99. ISBN 0-7216-2920-2. 
  • Edwards MS. "Osteomyelitis and Septic Arthritis"
Muscle weakness (or lack of strength) is a direct term for the inability to exert force with ones muscles to the degree that would be expected given the individuals general physical fitness. ... Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... Neuralgia is a painful disorder of the nerves. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Panniculitis is a group of diseases whose hallmark is inflammation of subcutaneous fatty and muscle tissue. ... Fibromyalgia (FM) is stated to be a disorder classified by the presence of chronic widespread pain and tactile allodynia. ... Bone disease refers to the medical conditions which affect the bone. ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Osteomalacia is a softening of the bones, resulting from defective bone mineralisation. ... Pseudarthrosis is the movement of a bone at the location of a fracture resulting from inadequate healing of the fracture. ... This article is about stress wienerfractures in bones. ... Monostotic fibrous dysplasia (or monostotic osteitis fibrosa) is a form of fibrous dysplasia where only one bone is involved. ... Skeletal fluorosis is a bone disease exclusively caused by excessive consumption of fluoride. ... An aneurysmal bone cyst is an expansile osteolytic lesion with a thin wall, containing blood-filled cystic cavities. ... Hyperostosis is an excessive growth of bone. ... Osteomyelitis is an infection of bone, usually caused by pyogenic bacteria or mycobacteria. ... Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. ... Bold text X-ray of Pagets disease Pagets disease, otherwise known as osteitis deformans, is a chronic disorder that typically results in enlarged and deformed bones. ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... Dissolution or degeneration of bone tissue through disease. ... In medicine, Chondropathy refers to a disease of the cartilage. ... Osteochondrosis is a orthopedic disease. ... Legg-Calvé-Perthes syndrome is a degenerative disease of the hip joint, where a loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. ... Osgood-Schlatter disease (also known as tibial tubercle traumatic apophysitis) is an inflammation of the growth plate at the tibial tuberosity. ... Köhler disease (also spelled Kohler) is a rare bone disorder of the foot found in children between six and nine years of age. ... Severs disease, or calcaneal apophysitis, is the most frequent cause of heel pain in children between the ages of 8 and 13 and is due to an inflammation of growing plates, the calcaneus in the back of the foot due to the rapid growth of bone when compared to... Osteochondritis Dessicans is when a loose piece of bone and cartilage seperates from the end of the bone because of a loss of blood supply and insuffecient amounts of calcium. ... Tietzes syndrome, also known as costochondritis, is a benign inflammation of one or more of the costal cartilages. ... // Q00-Q99 - Congenital malformations, deformations and chromosomal abnormalities (Q00-Q07) Congenital malformations of the nervous system (Q00) Anencephaly and similar malformations (Q01) Encephalocele (Q02) Microcephaly (Q03) Congenital hydrocephalus (Q04) Other congenital malformations of brain (Q05) Spina bifida (Q06) Other congenital malformations of spinal cord (Q07) Other congenital malformations of nervous...

  Results from FactBites:
 
Septic arthritis - Wikipedia, the free encyclopedia (376 words)
Septic arthritis is the proliferation of bacteria in joints and resultant inflammation.
Septic arthritis should be suspected when one joint (monoarthritis) is affected and the patient is febrile.
Septic arthritis by William Brinkman, M.D., University of Washington Department of Radiology
Septic Arthritis (3419 words)
Septic arthritis may present as polyarticular arthritis in about 10% to 19% of patients and is more common in patients with prior joint damage as in rheumatoid arthritis, gout, and systemic connective tissue disorders.
Septic arthritis in rheumatoid arthritis is associated with a higher mortality of 25% to 30% due to delay in diagnosis and initiation of treatment, as it may mimic an acute flare-up of the disease.
Polyarticular septic arthritis is seen in 10% to 19% of nongonococcal infections, usually due to staphylococcal infection of large joints in patients with underlying rheumatoid arthritis.
  More results at FactBites »


 

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